1. A 50-year-old obese man with a history of type 2 diabetes presents with fatigue and right upper quadrant abdominal pain. Liver function tests reveal elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Ultrasonography shows a hyperechoic liver consistent with fatty infiltration. Which of the following is the most likely diagnosis?
A. Alcoholic fatty liver disease
B. Nonalcoholic fatty liver disease (NAFLD)
C. Viral hepatitis
D. Autoimmune hepatitis
E. Wilson’s disease
2. A 45-year-old woman with a history of obesity and hypertriglyceridemia presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver. Which of the following is the most appropriate next step in evaluation?
A. Liver biopsy
B. Magnetic resonance imaging (MRI) of the liver
C. Screening for viral hepatitis
D. Screening for autoimmune hepatitis
E. Screening for Wilson’s disease
3. A 60-year-old man with a history of type 2 diabetes and obesity presents with fatigue and abdominal discomfort. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
4. A 55-year-old woman with a history of obesity and metabolic syndrome presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
5. A 65-year-old man with a history of alcoholism presents with fatigue and right upper quadrant abdominal pain. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most likely diagnosis?
A. Alcoholic fatty liver disease
B. Nonalcoholic fatty liver disease (NAFLD)
C. Viral hepatitis
D. Autoimmune hepatitis
E. Wilson’s disease
6. A 40-year-old obese woman with a history of polycystic ovarian syndrome presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
7. A 55-year-old man with a history of type 2 diabetes and hypertriglyceridemia presents with fatigue and abdominal discomfort. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
8. A 50-year-old obese woman with a history of hypertension presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
9. A 60-year-old man with a history of alcoholism presents with fatigue and right upper quadrant abdominal pain. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most likely diagnosis?
A. Alcoholic fatty liver disease
B. Nonalcoholic fatty liver disease (NAFLD)
C. Viral hepatitis
D. Autoimmune hepatitis
E. Wilson’s disease
10. A 45-year-old woman with a history of obesity and polycystic ovarian syndrome presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
11. A 55-year-old man with a history of type 2 diabetes and hypertriglyceridemia presents with fatigue and abdominal discomfort. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
12. A 50-year-old obese woman with a history of hypertension presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
13. A 60-year-old man with a history of alcoholism presents with fatigue and right upper quadrant abdominal pain. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most likely diagnosis?
A. Alcoholic fatty liver disease
B. Nonalcoholic fatty liver disease (NAFLD)
C. Viral hepatitis
D. Autoimmune hepatitis
E. Wilson’s disease
14. A 45-year-old woman with a history of obesity and polycystic ovarian syndrome presents with incidental finding of elevated liver enzymes on routine blood work. Ultrasonography shows a diffusely echogenic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation
15. A 55-year-old man with a history of type 2 diabetes and hypertriglyceridemia presents with fatigue and abdominal discomfort. Liver function tests reveal elevated AST and ALT levels. Ultrasonography shows a hyperechoic liver with no evidence of cirrhosis. Which of the following is the most appropriate management?
A. Initiate treatment with metformin
B. Initiate treatment with a statin
C. Initiate treatment with a fibrate
D. Recommend weight loss and lifestyle modifications
E. Recommend liver transplantation